Don't Try to Be the Psychiatrist

While I know it's tempting, don't try to be your own psychiatrist. Trying to be the psychiatrist is a mistake. Psychiatrists train for 10 years to decide how to help you. Do you have 10 years of training? These people treat others like you every single day and thus have years of clinical experience under their belt. Do you treat others and have years of clinical experience under your belt? For most of us, the answers are "no" and "no." When you try to be the psychiatrist, you hobble your own mental illness treatment. And the trust is, I see people doing it all the time.

What Is 'Being the Psychiatrist?'

What I mean by "being the psychiatrist" is going into your appointment with a specific treatment in mind and not listening to your psychiatrist's opinion on it. It's demanding a specific treatment no matter what. It's refusing to try a treatment recommended by your psychiatrist without even discussing it. It's thinking that you are the one with the prescription pad.

But let me just say this: If a psychiatrist were ill, he would see another psychiatrist, too, if he were smart. He wouldn't pull out his own prescription pad and decide what to prescribe. Why? Because everyone needs an impartial read on their situation for a whole host of reasons, and after all, a doctor who treats himself has a fool for a patient.

Why Can't You 'Be the Psychiatrist?'

Simply put, you will never understand everything a doctor does about your mental illness. You might know a drug name. You might know a drug's side effects. But do you know the contraindications? Do you understand the pharmacology? Do you know the warnings associated with it? And even if you know all that, do you know it for all your other options as well? Do you truly know how to compare and contrast your options using clinical data and experience to select the best option? My guess is you don't.

And if you're not considering your psychiatrist's presented options and opinions, you very well may be missing out on the best options for you. You may be missing out on the one that will make you better.

I should also mention that if you go to your psychiatrist's appointment and start telling him what to do or creating an argument, it really isn't going to help your relationship.

Don't Be the Psychiatrist, Be the Advocate

Now, no one says you shouldn't try to educate yourself -- you should. No one says you should have your own thoughts -- you should. No one says you shouldn't question your psychiatrist -- you should. Everyone makes mistakes, and that includes psychiatrists. What I'm saying is that, at the very least, you should treat your psychiatrist as an expert. You should treat him as someone with more knowledge and experience than you -- because that is who he is. 

When I have an appointment with my psychiatrist, he often asks me, "What do you want to do?"

He respects my expertise. I have been studying bipolar and its treatments for 20 years, and he knows it. 

But, unless I've come up with a plan that I've thoroughly researched, I generally throw it back to him and say, "What do you recommend?"

He then makes one or more recommendations, and then we discuss them. We then come to a conclusion and make a plan based on that. I am the advocate; I never confuse that with being the psychiatrist. Even though I know more things about bipolar disorder treatment than almost anyone else, I am not the doctor, period.

How Not to Be the Psychiatrist But Advocate for Yourself

This doesn't mean that your psychiatrist is always right; what it means is that you should give him the benefit of the doubt. Unless there is a safety reason why you know that you shouldn't, you should give his treatment a try. You should listen to him with respect. You should ask questions and add your own thoughts but not assume you are right just because you Googled something. A psychiatrist-patient relationship is a complicated one, but it's one that deserves respect going both ways.

Now, I know some psychiatrists don't allow for the advocation you require. If that's the case, that's another matter, and you likely need a different psychiatrist, but in most cases, the above is essential. Don't be the psychiatrist. Be the educated, respectful, knowledgeable, discusses-things-rationally, stands-up-for-themselves patient. There is a difference.